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Latest Publications from ISD Scotland

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This page presents the latest releases from ISD in chronological order, for the current calendar year. Please scroll down the list to view older items or quickly filter by Health Topic using the links below. All items listed linked to the publications page for their topic, where you can access the 'Publication Summary', 'Publication Report' and individual tables. For items from previous years please view our archive releases page.

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03 March 2015

Cancer Survival Statistics

Survival from cancer generally increased between the periods of diagnosis 1987-1991 and 2007-2011.

For all cancers combined (excluding non-melanoma skin cancer), five-year age-standardised relative survival in the period of diagnosis 2007-2011 was estimated as 48% for males and 54% for females.

Five-year age-standardised relative survival for males diagnosed in 2007-2011 varied from 3.6% for cancer of the pancreas to 93.4% for testicular cancer. For females, survival varied from 5.5% for cancer of the pancreas to 95.1% for malignant melanoma of the skin.

Five-year age-standardised relative survival increased by approximately 19 percentage points in males and by approximately 14 percentage points in females over the period covered by this publication.

The differences between males and females in five-year relative survival were comparatively high for some cancers. For females, survival was higher in malignant melanoma of the skin and cancers of the stomach, oral cavity and thyroid. For males, survival was higher in cancer of the bladder and multiple myeloma.

The total number of NHSScotland staff in post was 137,511.9 whole time equivalent (WTE) and 160,524 headcount at 31 December 2014. This is an increase of 1.8% and 1.5% respectively since 31 December 2013.

The largest group in the workforce continues to be nursing and midwifery, which accounted for 42.9% of all staff with 59,003.8 WTE at 31 December 2014.

The number of consultants in post (including Directors of Public Health) recorded has seen an annual increase of 6.4% (294.8 WTE) to 4,900.6 WTE at 31 December 2014. This is partly due to more complete recording of data as boards move to a new national HR system.

The total number of combined nursing and midwifery vacancies has decreased by 65.3 WTE since the last quarter to 2,088.3 WTE. However, the number of midwifery vacancies has increased by 29.8 WTE to 100.0 WTE.

There are 395.6 WTE consultant vacancies, 163.7 WTE have been vacant for more than six months, an increase of 44.9% (50.7 WTE) since September 2014.

During the quarter October to December 2014, 168,526 bed days were occupied by delayed discharge patients. This compares with 154,588 during the quarter July to September 2014 and 134,978 during the quarter October to December 2013.

Almost three quarters of total delayed discharge bed days are occupied by patients aged 75 and over.

At the January 2015 census, 329 patients were delayed over four weeks which is the national target. This compares with 321 at the October 2014 census and 254 at the January 2014 census.

There were 224 patients delayed for over six weeks at the January census. This compares with 215 at the October 2014 census and 151 at the January 2014 census.

At the January 2015 census, 517 patients were delayed over two weeks. This compares with 587 at the October 2014 census and 448 at the January 2014 census.

The principal reason for delay may change during an individual’s period of delay as arrangements for discharge are put in place. The principal reasons supplied for those who had been delayed for more than four weeks at the January 2015 census (329 patients) were as follows: Awaiting place availability in a care home – 161 patients; Waiting to go home – 95 patients; Awaiting community care assessment – 26 patients; Awaiting funding for a care home placement - 5 patients; Awaiting healthcare arrangements - 11 patients; Other reasons such as disagreements – 31 patients.

There were 336 patients reported as ‘Code 9’ delays where the current maximum delay does not apply. Of these, 61 per cent were due to the ‘Adults with Incapacity Act’.

During the month ending 31 January 2015: There were 129,269 attendances at A&E services across Scotland; 87.1% of attendances at A&E services were seen and subsequently admitted, transferred or discharged within four hours; 3215 (3%) patients spent more than 8 hours in the department; 703 (0.6%) patients spent more than 12 hours in the department; 29% of attendances led to an admission to hospital.

The total number of attendances in the last 12 months (1 February to 31 January 2015), and the same period in the previous 2 years were: 2015 - 1,645,639; 2014 - 1,611,887; 2013 - 1,639,159

The percentage seen and subsequently admitted, transferred or discharged within four hours in the last 12 months (1 February to 31 January 2015), and the same period in the previous 2 years were; 2015 - 92.3%; 2014 - 93.8%; 2013 - 94.1%

24 February 2015

For Scotland as a whole there has been a steady improvement in the recording of ethnic group over the last two years. Completeness of recording has improved by 5 percentage points to 82% for inpatient and day case records (SMR01) and by 9 percentage points to 74% for new outpatient appointment records (SMR00).

Increased recording of code ‘98’ –‘Refused/Not provided’ in SMR01 and SMR00 data has been seen at some Boards over the last eight quarters. This variation is being investigated locally.

In 2009, the Scottish Government committed central funding to expand the CAMHS workforce of NHSScotland. This has resulted in a steady increase in the CAMHS workforce from 764.6 WTE (883 headcount) in 2009 to 942.4 WTE (1096 headcount) as at 31st December 2014.

The most significant staff increases have been in Psychology (72% since 2009), and Nursing (22% since 2009).

The headcount has remained relatively stable over the past year. There are currently 1096 clinical staff (942.4 WTE). Nationally, this represents a staffing level of 17.7 WTE clinical workers per 100,000 of the population of Scotland.

An additional 48.8 WTE posts throughout NHS Scotland CAMHS were between being advertised and being filled. A further 11.2 WTE posts were approved for recruitment but not yet advertised.

Workforce Planning for Psychology Services in NHSScotland - Characteristics of the Workforce within Psychology Services

As at 31st December 2014:

The total number of clinical staff employed in NHSScotland Psychology Services continues to rise, with 1253 staff (1057.2 WTE) including 905 (756.8 WTE) Clinical and Other Applied Psychologists in post as at 31st December 2014.

There has been a significant increase over time in the number of Clinical and Other Applied Psychologists employed in NHSScotland from 426 (371.0 WTE) in 2003 to the current level of 905 (756.8 WTE) as at 31st December 2014.

This total of 905 (756.8 WTE) equates to 844 (705.3 WTE) Clinical Psychologists plus 61 (51.5 WTE) Other Applied Psychologists. This represents a national staffing level of 14.2 WTE Applied Psychologist per 100,000 of the general population of Scotland.

The total of 1253 staff also includes Graduates of the MSc in Psychological Therapies in Primary Care (64.2 WTE), Graduates of the MSc in the Applied Psychology of Children and Young People (37.1 WTE), Cognitive Behavioural Therapists (47.8 WTE), Counsellors (26.8 WTE), other therapists (17.2 WTE), and other clinical staff (20.1 WTE).

As at 31st December 2014, an additional 49.0 WTE posts throughout NHSScotland Psychology Services were between being advertised and being filled with start dates commencing in January 2015. A further 13.5 WTE posts were approved for recruitment but not yet advertised.

The Scottish Government set a target for the NHS in Scotland to deliver a maximum wait of 26 weeks from a patient’s referral to treatment for specialist CAMH services from March 2013, reducing to 18 weeks from December 2014. The target should be delivered for at least 90% of patients.

During the quarter ending December 2014, over 4,100 children and young people started treatment at CAMH services in Scotland.

During the quarter ending December 2014, 86.0% of people were seen within 26 weeks and 78.9% of people were seen within 18 weeks.

Waiting times information for Psychological Therapies are developmental. NHS Boards are working with ISD and the Scottish Government to improve the consistency and completeness of the information. The target that at least 90% of people waiting for Psychological Therapies should start treatment within 18 weeks is due for delivery from December 2014.

NHS Boards have had to develop new systems to enable reporting on Psychological Therapies waiting times.

During the quarter ending December 2014, just over 10,500 people started treatment for psychological therapies in Scotland. The initial estimates from data at this stage of development indicate that around 81% of people were seen within 18 weeks.

In December 2014, across NHS Scotland, 89.2% of patients whose 18 Weeks RTT journey could be fully measured, were reported as being seen within 18 weeks, compared to the amended previous publication (excluding NHS Highland) for September 2014 of 90.1%. The figures for October and November 2014 are 89.8% and 88.4% respectively.

In December 2014, a total of 100,939 of patient journeys eligible under the 18 weeks RTT standard were identified. The waiting time could be fully measured for 93,616 of these patients (92.7%). It was not possible to calculate the waiting time fully for 7,323 patients due to the complexity of linking individual patient journeys.

This publication release for quarter ending 31 December 2014, presents for the second time since the introduction of TTG, Inpatient and Day case statistics sourced directly from patient level data held by NHS Boards. This has allowed statistics to be compiled centrally using nationally consistent definitions and methods and will allow better comparison across the country and more robust data quality assurance.

During quarter ending 31 December 2014, 97.1% of Inpatients and Day cases were seen within the 12 week TTG. This has decreased from 97.3% during quarter ending 30 September 2014. Additionally, 9 out of 10 patients were seen within 77 days (11 weeks).

Of the 2,342 patients who were not treated within 12 weeks during quarter ending 31 December 2014, 45.9% were seen in NHS Lothian, 19.9% in NHS Grampian and 19.8% in NHS Highland.

At 31 December 2014, 96.9% of patients waiting for Inpatient or Day case admission had been waiting 12 weeks or less, this has decreased from 97.6% at 30 September 2014.

At 31 December 2014, 20.7% of patients waiting were recorded as being unavailable for treatment. This has increased from 18.8% of patients waiting at 30 September 2014.

New Outpatients

Figures from 01 April 2014 incorporate changes to the calculation of waiting times for New Outpatients. Although not enshrined in law, approval was given to use the same waiting times calculation for new outpatients as applies to Inpatients and Day cases under the TTG. This change will impact on the comparability of New Outpatient waiting times statistics over time.

At 31 December 2014, 90.8% of patients waiting for a new outpatient appointment had been waiting 12 weeks or less. This has decreased from 93.2% at 30 September 2014.

Of the 24,530 patients who were waiting over 12 weeks as at 31 December 2014 for a new outpatient appointment, 21.8% were reported by NHS Grampian, 17.2% by NHS Ayrshire & Arran and 16.3% by NHS Highland.

During the quarter ending 31 December 2014, 90.0% of new outpatients seen had waited less than 12 weeks. This has decreased from 90.6% during quarter ending 30 September 2014.

At 31 December 2014, 3.8% of patients waiting were recorded as being unavailable to attend a new outpatient appointment. This has decreased from 5.0% of patients waiting at 30 September 2014.

On 31 March 2009, the Scottish Government introduced the waiting time standard that patients waiting for one of the eight key diagnostic tests and investigations would be waiting no longer than six weeks.

As at 31 December 2014:

51,954 patients in NHS Scotland were waiting for one of the eight key diagnostic tests and investigations. This is 10% higher than list size at 31 December 2013.

90.3% of patients waiting for a key diagnostic test had been waiting less than six weeks. When comparing to the position at 30 September 2014 and 31 December 2013, this has decreased from 91.0% and 96.2% respectively.

The majority of the 5,018 patients waiting over six weeks in NHS Scotland were waiting to be seen in NHS Grampian (28.3%), NHS Fife (21.6%), NHS Ayrshire & Arran (17.6%) and NHS Lothian (13.1%).

During the quarter ending December 2014, 427 eligible patients were screened at an IVF Centre in Scotland.

The initial estimates from data at this early stage of development indicate that during the quarter ending December 2014 around 80% of eligible patients were screened for IVF treatment within 365 days. This compares to 71% in the quarter ending September 2014.

In school year 2013/14 a total of 54,573 valid height and weight measurements were recorded for children in Primary 1 in Scotland. This is approximately 92% of children in Primary 1.

Based on epidemiological thresholds used for population monitoring purposes:

In 2013/14, 76.4% of children in Primary 1 were classified as healthy weight, a small decrease on the 2012/13 figure of 77.5%.

The BMI distribution of children in Primary 1 has remained broadly similar over the period 2004/05 to 2013/14 with between 21% to 23% of children at risk of overweight and obesity combined and around 1-2% at risk of underweight. In 2013/14, 22.6% of children in Primary 1 were at risk of overweight and obesity combined and 1.0% at risk of underweight.

The prevalence of healthy weight amongst children in Primary 1 decreases as deprivation increases. In the least deprived areas (SIMD quintile 5), 81.1% of children were classified as healthy weight while in the most deprived areas (SIMD quintile 1) 73.2% were classified as healthy weight.

The prevalence of healthy weight is slightly higher amongst girls than boys. In school year 2013/14, 77.2% of girls were classified as healthy weight compared to 75.7% of boys.

There were 1512 Upper GI cancer patients treated across NHSScotland in 2013, of which 364 were treated in NOSCAN, 725 in WoSCAN and 413 in SCAN.

Overall performance against the 11 Upper GI cancer QPIs is generally good across all NHS Boards; however no individual NHS Board met all 11 QPI targets. This suggests that the target levels for the QPIs are challenging and that there are areas for improvement.

Overall the postoperative mortality rates following Upper GI cancer resection in Scotland were low at 4% and below the QPI target of 10%.

The target of 35% of patients receiving curative treatment was not met by any of the three Networks. It is believed this reflects the advanced stage of disease at diagnosis and other health problems of patients. The best way to achieve this target is through earlier detection of Upper GI cancer.

03 February 2015

Emergency Department Activity & Waiting Times

The number of attendances at A&E services across Scotland over the last 3 years were: 2014 – 1,645,200; 2013 – 1,608,789; 2012 – 1,642,816

During the quarter ending 31 December 2014, the proportion of attendances at A&E services that were seen and subsequently admitted, transferred or discharged within four hours were: October – 91.8%; November – 91.8%; December – 89.9%

During the quarter ending 31 December 2014, 4028 (1%) patients spent more than 8 hours in the department, and 517 (0.1%) spent more than 12 hours in the department.

During the quarter ending 31 December 2014, 27% of attendances at A&E led to an admission to hospital.

Scottish Antimicrobial Prescribing Group (SAPG) Report on Antimicrobial Use and Resistance in Humans

In 2013, the use of antibacterials in primary care was lower than in 2012. This reduction was observed both in terms of antibiotic items (down 5.4%) and Defined Daily Doses (down 2.5%).

In 2013 an increase of 1.6% was observed in the total use of antibacterials in hospitals compared to 2012. This continues the upward trend seen since 2009, however the rate of increase is less than it has been for previous years.

A continued increase in the use of carbapenems in Scottish hospitals was observed. However, the increase from 2012 to 2013 was lower than that of previous years. Despite this rise resistance to carbapenems among Gram-negatives remains low, with 0.2% of K. pneumoniae and none of the E. coli isolates being resistant to meropenem.

However, the epidemiological status of carbapenemase producers in Scotland recently changed from ‘sporadic’ to ‘regional spread’ following two incidents of local spread reported in 2014. An increase in meropenem resistance was also observed among Scottish E. coli urinary isolates (from 0% in 2012 to 0.03% in 2013)

There was continued progress in 2013 toward reduction in the use of broad spectrum antibacterials associated with Clostridium difficile infection (CDI) in primary care with a 12.7% decrease

There was a 4.5% increase in the use of co-amoxiclav in secondary care in 2013 as compared to 2012. This coincided with an increase in resistance to co-amoxiclav among E. coli bacteraemias from 18.4% in 2012 to 28.4% in 2013, above that reported in 2009-2011 (range: 23.4%-25.4%).

The use of piperacillin-tazobactam has continued to rise, with a 7.4% increase in 2013 as compared 2012. The high resistance (8.6% in 2013) to piperacillin-tazobactam among E. coli bacteraemias is of concern due to its frequent clinical use.

Cerebrovascular disease (CVD) develops as a result of problems with the blood vessels supplying the brain. The number of new cases of CVD in Scotland has decreased over the last decade. The incidence rate of CVD in Scotland was 328.9 per 100,000 population in 2004/05 compared to 257.4 per 100,000 in 2013/14, a decrease of 21.8%. Incidence rates for CVD are consistently higher in males than females.

The decrease in mortality rates for stroke in men (43.1%) has been greater than for women (39.3%). For the last three years, the stroke mortality rate for women has been slightly higher than that for men.

The percentage of people surviving 30 days or more following their first emergency admission to hospital with a stroke has improved slightly over the last 10 years from 80.8% in 2004/05 to 84.9% in 2013/14.

Although the number of prescriptions for drugs to treat cardiovascular disease (all diseases of the circulation, including stroke) increased by 16.9% in the last 10 years, the overall costs of prescriptions dispensed for cardiovascular drugs fell in 2013/14 to £102.9 million, a reduction of 7.8% on the previous year. This is the lowest cost for these drugs over the last ten years (since 2004/05). Costs may continue to reduce as medicines become available in less expensive, non-branded (generic) form.

Two NHS Boards (NHS Lanarkshire and NHS Shetland) met the H9 HEAT target of 60% of children aged three years old and those aged four years old receiving two or more FV treatments in 2013/14 for all quintiles of deprivation.

There has been an increase in the number of children receiving FV treatment across Scotland, and within each of the NHS Boards.

The data shows a clear deprivation gradient within Scotland and in the majority of the NHS Boards, with children in the most deprived quintiles most likely to receive FV.

Nationally the total number of 3 year old children receiving two or more FV treatments has increased from 12,192 in 2012/13 to 19,320 in 2013/14.

Nationally the total number of 4 year old children receiving two or more FV treatments has increased from 13,068 in 2012/13 to 21,235 in 2013/14.

Coronary heart disease (CHD), which includes heart attacks, is a leading cause of illness and death in Scotland.

The number of new cases of CHD (incidence) has decreased over the past decade. The age and sex standardised incidence rate decreased by 30.4% between 2004/05 and 2013/14.

There has been a steady downward trend in deaths from CHD in Scotland, UK and Europe over the last 10 years with the mortality rate in Scotland falling by 43.2%.

The reduction in death rates for CHD over the decade 2004-2013 has been seen in both the most and least materially deprived communities. The percentage reduction in deaths in the most deprived category (40.7%) over the last 10 years is smaller than that in the least deprived category (46.4%). However, the absolute difference in the death rate between the most and least deprived areas has decreased over the last decade.

For those admitted to hospital as an emergency with their first heart attack, the chances of surviving at least 30 days have improved over the last ten years from 85.1% to 91.8%.

13 January 2015

ScotPHO Tobacco Control Profiles

Update to Tobacco control profiles on the ScotPHO website, including some new indicators at National Local Authority and Health Board level. The tool includes spine charts, rank charts and time trends.

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